- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $229.09 / $489.78
| Professional | | $125.89 | $229.09 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $288.40 / $426.58
| Professional | | $208.93 | $288.40 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $229.09 / $416.87
| Professional | | $131.83 | $229.09 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $380.19 / $426.58
| Professional | | $302.00 | $380.19 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $257.04 / $407.38
| Professional | | $131.83 | $257.04 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $257.04 / $660.69
| Professional | | $128.82 | $257.04 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $426.58 / $524.81
| Professional | | $186.21 | $426.58 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $239.88 / $912.01
| Professional | | $117.49 | $239.88 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $199.53 / $371.54
| Professional | | $114.82 | $199.53 | $371.54 |